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Plate Fixation of Middle-Third Clavicle Fractures in the Semi-Professional Athlete

Authors: Olivier Verborgt

References: Poster Presentation at AAOS 2005

Abstract
This study shows good results and early return to sportsactivity after plate fixation of middle-third clavicle fractures in the athlete.

Unless a neurovascular compromise or significant displacement exists, fractures of the middle-third of the clavicle are treated conservatively. However, prolonged recovery and impaired shoulder function may occur and are not very well tolerated, especially by the athlete. The purpose of this study was to evaluate plate fixation of middle-third clavicle fractures in semi-professional athletes.

Thirty-nine semi-professional athletes (mean age of 25.5 years) with a displaced fracture of the middle-third of the clavicle were acutely treated by open reduction and internal plate fixation. All patients were assessed radiographically and clinically at 1, 6 and 18 weeks. At clinical review, the functional outcome was assessed by the Constant Murley score, a visual analogue pain score (0 is no pain, 10 is severe pain), return to sports status and by the patientÂ’s subjective satisfaction rating.

At 6 weeks post-operatively, the mean Constant score was 88 points, the visual analogue pain score was 3 out of 10 and the average time for return to sports was 45 days. Seventy-five percent of the patients were very satisfied and 95 percent of the patients would chose to have the same operation again. Thirtu-seven patients showed union on the radiographs at 18 weeks, 2 patients sustained a refracture after a new trauma. Eighteen percent developed a woundinfection.

This study suggest that plate fixation of acute middle-third clavicle fractures results in good subjective and functional outcome in the semi-professional athlete and may result in early return to sportsactivity.

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